TITLE:
Materno-Foetal Morbidity in the Second Stage of Labour: A Cohort Study in Primiparous Women in Yaounde
AUTHORS:
Félix Essiben, Khadidja Bayero, Hapsatou Ahmadou Djoulatou, Maye Ange Ngo Dingom, Julius Sama Dohbit, Cliford Ebontane Ebong, Pascal Foumane
KEYWORDS:
Second Stage of Labour, Duration, Primiparas, Morbidity, Yaounde
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.12,
December
22,
2021
ABSTRACT: Introduction: Prolonged Second Stage of Labor (SSL) is known
to increase maternal and foetal morbidity. We, therefore, aimed to assess for
the occurrence of complications of the SSL in relation to its duration in
primiparous women in Yaounde. Methods: It was a cohort study carried out
at the Yaounde Gynaeco-Obstetric and Paediatric Hospital over a period of 6
months, from December 19, 2018 through May 3, 2019. We included for the study
nulliparous pregnant women with singleton pregnancies and normal uteri. Data
collected were analysed using EPI info 7 and SPSS version 2.0 software. Results: Amongst 327 nulliparas, the SSL lasted more than one hour in 120 (36.7%), and
more than two hours in 42 (12.8%). The most common maternal complications observed
were genital lacerations (23.6%; 28/120), instrumental deliveries (20.2%,
24/120), post-partum haemorrhage (8.9%). Foetal complications included caput
succedaneum (15.2%; 18/120) and perinatal asphyxia (7.5%; 9/120). Maternal
complications were significantly increased in women with an SSL lasting 1 - 2 hours (44.9%
versus 22.7%; p 0.001) and >2 hours (42.9% versus 22.7%; p = 0.007). Similarly,
for foetal complications 23.1% occurred with SSLs between 1 - 2 hours (versus
6.3%; p 0.001) and 19.0% for SSLs > 2 hours (versus
6.3%; p = 0.007). Conclusion: Maternal and foetal complications increase when the SSL exceeds 1 hour in
primiparas. Identifying factors that predispose to a prolonged SSL and
indicating appropriate interventions could help prevent morbidity.